Find a doctor in your health insurance network to save money

Don't be afraid to ask questions and shop around when choosing a family doctor. (Photo by Katie Jacewicz)

Don't be afraid to ask questions and shop around when choosing a family doctor. (Photo by Katie Jacewicz)

If you have health insurance, you can save money and sometimes receive other benefits by seeing a doctor in your network. If you go to a physician who's not on the health insurance provider's list, some insurance companies won't cover as much for the appointment, and others won't pay anything. So know what choices you have with your plan.

First, find out what kind of plan you have. Health insurance providers can be a bit confusing, so you may need to talk to your agent to understand your specific plan. The limits imposed on which doctors you can visit depend partly on whether you have an HMO (health maintenance organization), PPO (preferred provider organization), POS (point-of-service) or traditional plan. Each plan has its differences.

Some HMO plans will actually assign you a specific family doctor that you have to go to if you want any kind of coverage. Other plans are more flexible, but you should always ask about network doctors to make sure.

Even with a HMO, you can generally switch to another primary care provider if you choose someone who is also in the insurance network. In some cases, you may discover that your first choice is unavailable or currently not taking new patients.

If you go to the hospital for more complex treatment that involves more than one medical person, always ask about out-of-network workers doctors who may be taking part. When you receive an itemized bill, double check that the care you received is what you asked for.

Watch out for anesthesiologistsradiologists and pathologists who don't always sign on to the hospital network. Outside specialists, especially those consulted as part of your treatment, but not actually present, can also be pricier than expected. Cardiologists often fall into this category.

If you don't understand your condition or what kind of treatments you'll be undergoing, sit down with a doctor or a hospital representative to get a price quote. It's perfectly acceptable to be honest about your concern with your insurance. It's a common question, and most medical personnel and those who work with them already have the answers on hand.

Sometimes the doctor is on the list, but the hospital or other facility isn't. This means that your insurer will cover the fees tied to your care but not those relating to any payments owed the hospital itself for use of its space and equipment.

When you know in advance that you will be getting medical treatment, it can really pay off to do your research. If an in-network doctor can do the job at a hospital that's also on the network list, that's your best option. Ask them to accommodate your insurance policy and to provide you with all the information you need to make a responsible decision.

  • From 2008 to 2011, the average annual deductible for employer-sponsored health care coverage went up 17.2 percent for individuals using in-network doctors.

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Be proactive when seeking health care to achieve quality care at reasonable cost. (Photo by Karen Geswein)
Be proactive when seeking health care to achieve quality care at reasonable cost. (Photo by Karen Geswein)

As more health care plans turn to high-deductible, consumer-driven models, health consumers need to make savvy health care spending decisions including selecting in-network services, comparing prices and negotiating costs.

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